Surgical instrument

ABSTRACT

Surgical forceps for cutting and removing skin sutures, comprising tweezerlike grasping arms with a suture-receiving lateral slot near the tip of one arm, and a member intermediate the arms which advances across the slot to part a suture held there, when the arms are squeezed together.

United States Patent Inventor James Bernard Turner Foster Baltimore, Md. (67 W. 37th St., Bayonne, NJ. 07002) Appl. No. 861,657 Filed Sept. 29, 1969 Patented Apr. 27, 1971 SURGICAL INSTRUMENT 15 Claims, 14 Drawing Figs.

US. (I 30/124, 7/1P, 128/354 Int. Cl B25f 1/04 Field of Search 30/ 1 24,

Primary Examiner-Robert C. Riordon Assistant Examiner-LC. Peters Attorney-John F. McClellan, Sr.

ABSTRACT: Surgical forceps for cutting and removing skin sutures, comprising tweezerlike grasping arms with a suturereceiving lateral slot near the tip of one arm, and a member intermediate the arms which advances across the slot to part a suture held there, when the arms are squeezed together.

I SURGICAL INSTRUMENT This invention relates generally to surgical instruments, and

' specifically to surgical forceps for cutting and removing skin majority of cases, with interrupted sutures. These sutures are not intended to be permanent, but merely to hold the skin edges together during healing in order to minimize the scar, and possible infection. They are meant to be removed, usually after several days.

Interrupted sutures are placed individually, with a'curved'or straight needle, and individually knotted, leaving the free ends relatively long to facilitate subsequent removal. They are usually removed by grasping the loose ends with a forcepsheld in one hand and, while the suture is under this slight tension,

cutting the thread between the knot and the skin with a pair of scissors, held in the other hand. Then they are drawn out with the knotted cut end leading. This traditional method has the disadvantages of requiring two instruments, which increases the expense and inconvenience of equipment and maintenance; and two hands, which are relatively unsupported. Having no free hand makes the procedure inconvenient: in some locations, where steadying is desirable; and dangerous in instances such as those involving a struggling child, where' restraint would be helpful.

Various combined cutting and grasping devices have been proposed to solve these problems, but none has found general acceptance because of awkwardnessesin design and use; and undue expense.

As a principal object of my invention, therefore, I propose to combine the grasping capability of the forceps, and. the

cutting quality of scissors, in a single instrument in all respects suitable for being held and operated by one hand.

Other objects of my invention are to provide an instrument of the type described: which has the general formand accustomed mode of use of ordinary tweezers; which. can be closed about the suture in a single tweezerlike motion at. once severing the suture loop and, if desired, seizingthefree end at the knot, ready for withdrawal of the suture; which is adapted for removal of sutures having knotsto the left or to the right of the user by means of simple reorientation of the instrument in the hand of the user; which has the suture-cutting structure so positioned as to prevent revealment of edges possibly injurious to patient or user.

Other objects of my invention are to provide an instrument of the type described which in various embodiments offers a variety of cutting actions, including shearing as with scissors, slicing as with angled blade, andchopping as..withblade against block; which in various embodiments aflords slotted structure specifically adapted to address sutures to the parting edge; which in various embodiments affords integral lateral support and concealment for the parting mechanism; and

which in all embodiments is exemplified by a minimum-of parts, relatively inexpensive materials, and assembly adapted for high-volume automatic machine production according to known practice, making the instruments economically disposable after single use.

Essence of the invention, then, lies in provision of a tweezerlike instrument having parting means disposed laterally between the grasping tips thereof, including a. lateral slot in the lower arm and a member'advanced'across the slot by pressure on: the arms when the instrument is'manipulated in the ordinary manner of tweezers.

These and other objects and advantages of my invention will be more readily understood on examination of the specification, and the drawings in which:

FIG. 1 is a side elevation of av generalized representation of embodiments of my invention;

FIGS. 2a and 2b are fragmentary details viewed along 2-2 of FIG. 1;

FIG. 3 is a fragmentary detail in perspective of forceps structure removing a suture;

FIG. dis a section of a detail similar to that of FIG. 2;

bodiments of my invention.

Discussing now each of the FIGS. in turn, in FIG. 1 reference numeral 10 indicates a generalized representation of some of the embodiments of my forceps. Upper arm 12 and lower arm 14 are integrally united in a tweezer configuration at joinder 16. The arms are preferably made of a plastic material which. is rigid but not brittle, such as methyl methacylate or the like and formed as a unit by injection molding. They may alternatively, be metal.

An elongated, resilient, inner member 18 is integrallyfixed at one end 20 to the tweezer structure. The inner member is from this point deployed parallel with the upper arm for a distance and then diagonally downward to a free end 22 in contact with the lower arm, short of the tip 24.

The inner member 18 may be metal, or plastic, depending on the exact embodiment of the invention, as will be seen. It will be seen also that regardless of material chosen, the inner member actsas a spring, biasing the arms apart.

The upper arm may be grooved longitudinally on the lower side as at 32 to accommodate part of resilient member 18, stabilizing the member laterally.

The lower arm is laterally slotted in an area 26 which lies just beyond the end 22 of inner member 18 when the instrument is in the relaxed, or nongrasping, position shown.

When the arms'are pressed toward each other by the user, thediagonal section 28 of the inner member is straightened, and the end 22 is consequently advanced across slot 26 as the arm tips 24 and 30 come together. In the various embodiments of my invention, this advancing motion of the inner member coacts with the slot to part a suture positioned in theslot, just as the device grasps the suture preparatory to removal.

FIGS; 2a and 2b illustrate a detail of'the lower arm 214 of an embodiment generally like that of FIG. 1, in which the inner member 218 is preferably composed of any one of a number of edge-taking but relatively cheap metals, such as the carbon steels commonly used for edged tools. The free end 222 of the inner member is beveled on the upper side, and lies in contact with arm 214 short of slot 226 when the forceps are in the relaxed position, as in FIG. 2a.

When the forceps are squeezed by the user, causing the tips to come together for grasping, the inner member 228 advances across the slot, as in FIG. 2b, shearing apart any suture caught in the slot.

The slot 226 in the FIG. 2 embodiment is canted, the opening being angled somewhat away from the tip of the arm 214, forming a hook' for constraining sutures against the action of the advancing, edge. The edged end 222 of the inner member is canted oppositely to the slot, so that the canted edges tend to trap sutures in the closed end of the slot, and to slice, rather than'chop, the sutures.

FIG. 2b shows the position of the inner member 228 at the end of the cutting stroke. The edged end 222 of inner member 218 has passed along the lower arm 214 over slot 226.

It can be seen that the slot in any of the embodiments could, to suit special applications, be canted toward the tip, providing a forked receiver instead of a hooked receiver for sutures.

FIG. 3 is a detail of an embodiment like that of FIG. 2', at the FIG. 2b position, showing the device grasping a suture subsequent to parting the suture.

Two novel features appear in FIG. .3. The first is a snap-in assembly arrangement of inner member 318 in which it is recurved at 304- and secured in the lower arm, within and against the end of recess 308. The other novel feature is channeled lug 332 which receives-and guides the inner member.

Either or both these features may be used in other embodiments.

FIG. 4, a vertical section taken through a detail like that of FIG. 2b, shows a further refinement in cutting action provided in one embodiment of the invention, a beveled outer edge 434 of the slot 426. This bevel forms a cutting edge opposed to the edge 422 of the resilient member 418, to provide a scissorlike suture-clipping action. The tweezer body, the lower arm, or the tip of the lower arm, can be made of metal to enhance this action.

A portion of suture S is shown in section, as grasped by the instrument subsequent to parting of the suture.

FIG. 5 and 6 are details in plan and vertical section respectively, showing several features which may be employed together, or one or more individually, in this and the other embodiments of my invention. Edged end 522 of resilient member 518 and slot 526 are perpendicular to the long axis of the forceps in this embodiment. Lower arm 514 has a longitudinal groove 536 in the upper surface, which accommodates at least a part of the thickness of the inner member 518. As best shown in FIG. 6, this groove has three functions. The groove guides the inner member 518 and, in the relaxed forceps position, conceals the edge 522 of the inner member. The groove also recesses the inner member'with respect to the tip 524, so that the outer edge 534 of the slot serves as a chopping block against which inner member edge 522 chops. Such chopping action may be found particularly suitable for some applications.

The recess also allows use of a thicker inner member.

' FIG. 7 shows a further embodiment of my invention which provides a fixed edge 734 at the slot 726, as at 434 in FIG. 4, but which employs a blunt end 722 on the inner member 7E8.

A groove 736 may be used in this embodiment, as well as in the other embodiments, to recess the thickness of the inner member entirely. The blunt end 722 is here arranged to pass over the slot 726 as shown, and to remain in the extension of the groove.

Alternatively the blunt end may be arranged to drive against the edge, as element 822 drives against element 834 in FIG. 8.

FIGS. 9a and 9b depict in perspective an improved lower arm tip 924. The upper arm is of conventional design, but is omitted here, for clearer exposition. Tip 924 is reduced to an edge around the outer margin, tapering in section into the arm 914 lying beyond slot 926, as shown. The edged tip and slot region penetrates encrustations, and can he slipped with minimum disturbance under tightly drawn sutures S, to part them as shown.

FIG. 10, at 100, illustrates the general form of the embodiments of FIG. 11 and FIG. 12, in which the inner member 1018 depends from the upper arm I012, apically directed as before. Coacting slot 1026 is provided as in previous embodiments. A groove, not shown, in the lower arm, may also be used to guide the end of the inner member and to conceal the edge in the relaxed-forceps position.

The material of this embodiment may be plastic-or metal, with the inner member molded integral with, affixed to, or lanced out of, the upper arm, according to normal fabrication techniques.

FIG. 11 illustrates a detail of the upper arm of an embodiment similar to that of FIG. 10, in which inner member 1118 has been lanced out of arm 1112. Visibility around the operative site is somewhat improved by opening 1M0.

FIG. 12 illustrates a detail of an embodiment similar to that of FIG. '11, in which the tip of the upper arm I212 is split laterally into divisions, consisting of inner member 1218, and

paired independent tips 1242, which are flexibly adapted to grip thin sutures or bulky knots as the case may be. Visibility is also improved in this version. In this FIG. as in FIG. 10, the inner member 1222 is shown as being beveled on the lower side. This avoids any tendency of the edge to gouge the lower arm.

In all embodiments the width relation of the inner member and slot areapproximately as shown in FIG. 2 Obviousl the instruments are as efficient in right-hand as in lefl-han embodiments, but a simple reversing of the instrument in the hand will provide for grasping sutures having knots alternated to the left or to the right.

Although, for purposes of illustration, various aspects of my invention have been described in detail, it will be noted that the invention may be practiced otherwise than as specifically detailed without departing from the spirit thereof.

Iclaim:

1. Surgical forceps for coordinate parting and grasping of skin sutures, comprising: tweezer means having joined upper and lower arms with opposed tip means for grasping; structure defining a suture-receiving slot opening lateral of the lower arm near the tip; and means cooperative with'the slot for suture parting, consisting of an inner member having one end adjacent the slot and substantially laterally coextensive with the slot, with the other end affixed tothe tweezer means, and an intermediate length thereof diagonally deployed between the arms for advancement of said one end across the slot on compressive straightening of the inner means between said arms.

2. Surgical forceps as recited in claim 1, wherein said one end of the inner member comprises a cutting edge laterally extending between said opposed tips next adjacent the lower arm.

' 3. Surgical forceps as recited in claim 2, wherein the slot in the lower arm is canted.

4. Surgical forceps as recited in claim 3, wherein the lateral extent of said one end of the inner member is canted oppositely the cant of the slot.

5. Surgical forceps as recited in claim 1, wherein the lower arm has a groove receiving a substantial portion of the thickness of the inner member and guiding said one end thereof.

6. Surgical forceps as recited in claim 1, wherein said slotdefining structure includes a sharp upper edge of the slot adjacent said tip.

7. Surgical forceps as recited in claim 2, wherein said slotdefining structure includes a sharp upper edge of the slot adjacent said tip, and wherein said laterally extending cutting edgeis adapted to pass over the sharp upper edge.

8. Surgical forceps as recited in claim 1, wherein said other end of the inner member is affixed at the joinder of the arms.

9. Surgical forceps as recited in claim 8, wherein the upper arm has structure for guiding the inner member at said intermediate length thereof.

ltl. Surgical forceps as recited in claim I, wherein the inner member originates at said other end intermediate the length of an arm and wherein said other end is recurved toward said tip means.

11. Surgical forceps as recited in claim 1, wherein the inner member originates at said other end intermediate the length of the upper arm, and wherein the upper arm has an opening above a portion of the inner member.

12. Surgical forceps as recited in claim 11, wherein the opening divides the tip of the upper arm.

i3. Surgical forceps as recited in claim 2, wherein said slotdefming structure includes a raised portion adapted to receive cutting edge thereagainst on advancement of said one end of the inner member across the slot.

14. Surgical forceps as recited in claiin 1, wherein the tip of the lower arm is reduced to an edge around the outer margin, with the edge tapering in section into the arm beyond said slot.

15. Surgical forceps as recited in claim 10, wherein the upper arm has recessed means for receiving and guiding a portion of said intermediate length of the inner member, and wherein the lower arm has recessed means for receiving and fixing said recurved end. 

1. Surgical forceps for coordinate parting and grasping of skin sutures, comprising: tweezer means having joined upper and lower arms with opposed tip means for grasping; structure defining a suture-receiving slot opening lateral of the lower arm near the tip; and means cooperative with the slot for suture parting, consisting of an inner member having one end adjacent the slot and substantially laterally coextensive with the slot, with the other end affixed to the tweezer means, and an intermediate length thereof diagonally deployed between the arms for advancement of said one end across the slot on compressive straightening of the inner means between said arms.
 2. Surgical forceps as recited in claim 1, wherein said one end of the inner member comprises a cutting edge laterally extending between said opposed tips next adjacent the lower arm.
 3. Surgical forceps as recited in claim 2, wherein the slot in the lower arm is canted.
 4. Surgical forceps as recited in claim 3, wherein the lateral extent of said one end of the inner member is canted oppositely the cant of the slot.
 5. Surgical forceps as recited in claim 1, wherein the lower arm has a groove receiving a substantial portion of the thickness of the inner member and guiding said one end thereof.
 6. Surgical forceps as recited in claim 1, wherein said slot-defining structure includes a sharp upper edge of the slot adjacent said tip.
 7. Surgical forceps as recited in claim 2, wherein said slot-defining structure includes a sharp upper edge of the slot adjacent said tip, and wherein said laterally extending cutting edge is adapted to pass over the sharp upper edge.
 8. Surgical forceps as recited in claim 1, wherein said other end of the inner member is affixed at the joinder of the arms.
 9. Surgical forceps as recited in claim 8, wherein the upper arm has structure for guiding the inner member at said intermediate length thereof.
 10. Surgical forceps as recited in claim 1, wherein the inner member originates at said other end intermediate the length of an arm and wherein said other end is recurved toward said tip means.
 11. Surgical forceps as recited in claim 1, wherein the inner member originates at said other end intermediate the length of the upper arm, and wherein the upper arm has an opening above a portion of the inner member.
 12. Surgical forceps as recited in claim 11, wherein the opening divides the tip of the uPper arm.
 13. Surgical forceps as recited in claim 2, wherein said slot-defining structure includes a raised portion adapted to receive cutting edge thereagainst on advancement of said one end of the inner member across the slot.
 14. Surgical forceps as recited in claim 1, wherein the tip of the lower arm is reduced to an edge around the outer margin, with the edge tapering in section into the arm beyond said slot.
 15. Surgical forceps as recited in claim 10, wherein the upper arm has recessed means for receiving and guiding a portion of said intermediate length of the inner member, and wherein the lower arm has recessed means for receiving and fixing said recurved end. 